The target market of the typical Audiology/Dispensing office consists primarily of hearing impaired adults over the age of 50. The first thing every employee in your practice should learn is how to communicate with the hearing impaired. As professionals who deal with the hearing impaired we have been inundated with lessons on how to communicate with the hearing impaired. Too often we forget that our staff does not gain this knowledge through osmosis.
How to Communicate with Your Target Market
I’d suggest you begin with a role play exercise. The purpose of this exercise is for your employees to experience, however briefly what your target market experiences when they contact your office. Each staff member should have the opportunity to be both the “patient” and the “front desk person”.
The key component of this exercise is to make the person playing the “patient” hearing impaired. Establish air conduction threshold levels for each staff member and then establish threshold levels while they are wearing earplugs. Although earplugs will most likely create only a mild hearing loss, the sudden onset should unsettle the “patient” enough for demonstration purposes.
Start with a Phone Call
This session should last approximately an hour. Begin by splitting the group in half, “patients” and “front desk person”. Place the “front desk person” at the front desk and the “patients” in an exam room. Begin the session by having one “patient” call the office for an appointment. Provide no script or feedback at this junction. The purpose of the role play is so that the “patient” gains insight into what it’s like to be a member of the hearing impaired community. If there are an even number of “patients” and staff and sufficient phone lines more than one patient/staff conversation can occur at the same time.
Next move to the front desk area, you want to create the same situation patient/staff, role paying while checking patients in at the front desk.
After everyone has had an opportunity to be both the patient and the staff member discuss the following?
- Was communicating on the phone harder than you thought it would be?
- Did you have a difficult time communicating with the “front desk person”?
Discuss how your staff can improve how they communicate with the hearing impaired.
- Think about how fast you speak. Slower will make you easier to hear and to understand.
- Facing someone with a hearing impairment and allowing them to see your lips will make your words more understandable.
- Use body language and gestures to help get the point across.
Your Staff also needs to understand that many of your patients will have issues in addition to a hearing impairment.
Sight loss can slowly develop from gradual aging, or it can strike as suddenly as a disease or injury. It can involve anything from wearing thick glasses to seeing only straight ahead, to seeing blank spaces or blurs or only light and darkness.
- Make an effort to avoid nonverbal responses, such as nods or headshakes. Remember that body language, like outstretched arms or facial expressions, may be un-seeable.
- Smiling when you talk is one exception to this rule; the patient may not see it, but it will come through when you speak.
- When you first approach a blind person, always say, “Hello,” followed by a reassuring pat on the arm or shoulder or a handshake. If it’s someone you don’t know, introduce yourself.
- Don’t be afraid to use common expressions like, “Nice to see you”; even blind people say it.
Confusion and Memory Loss
Confusion can cause memory loss, or memory loss can cause confusion. So can infection, dehydration or medication. Someone who clearly remembers an event that took place ten years ago may completely forget something you said ten seconds ago. He or she may keep asking you the same question over and over again—not just because they forgot your answer, but because they forgot they even asked the question.
In addition to being very patient, there are practical communication steps you can take to help confused relatives remember things and become less dependent on you:
- Patience is a virtue it is not just a saying. You may need to repeat something more than once, not because the patient was unable to hear the question, but they were unable to process the question.
- Your staff needs to understand that someone with a processing disorder when presented with the following list of commands
- “I need your insurance card, please fill out this form and the Audiologist will be with you in a moment.”
- May process only the last or first command.
- Instead the staff member may need to say.
- “I need your insurance card.”
- Once the staff member has the card they can say, “Please fill out this form.”
- Wait a moment and then say “Please have a seat.”
- Make written reminders specific—“Your appointment with Dr. Goldman is 11 AM on Thursday, May 16,”
Patient’s who have lost the ability to speak through stroke, voice-box removal or brain injury create a special challenge. Because in addition to speaking clearly, respectfully and reassuringly, you now have to decipher what the patient wants to say. Exactly what and how heavy this burden is can often depend on what caused the speech loss:
- Someone who had his or her voice box removed is probably more prepared for speech loss. A special device may be fitted to permit speaking with air belched from the stomach.
- Patients who have suffered a brain injury may be able to speak but unable to find the right word. Always keep pencil and paper on hand so the patient can write instead of talking. Keep on hand means a notepad and pen should be set aside for this purpose. At times, appearances are everything and being prepared for these types of situations demonstrates your commitment to every patient’s needs, not just patients who require no extra effort.
- Just as the name implies, the speech loss that strokes cause can be sudden. This can be particularly disconcerting to staff members when the patient is an existing patient.
Remember that whether it’s a hearing, vision, memory, or speech impairment, the patient is still likely to be mentally alert. Treat them with respect; never patronize them or talk down to them. Word of mouth can make you or break you. Bad news travels much more quickly than good news, but good news does get around.